Submucosal Tunneling Endoscopic Septum Division for Congenital Pseudo-Pylorus: A New Technology in a Rare Disease (With Video)

Xinyang Liu, Ying Fang, Hong-Bin Yang, Xiao-Xia Ren, Ya-Nan Han, Quan-Lin Li and Ping- Hong Zhou

Department of Endoscopy, Fudan University, China
Department of Gastroenterology, The Children’s Hospital of Xi’an City, China

^*Correspondance to: Ping-Hong Zhou 

 PDF  Full Text DOI: 10.25107/2474-1647.2169

Abstract

Background: Pseudo-pylorus is a congenital or an acquired septum (secondary to ulcer scaring) in the antral area that might simulate the pylorus. It could easily cause obstruction thus requires intervention. We report the use of Submucosal Tunneling Endoscopic Septum Division (STESD) on a pediatric case of congenital pseudo-pylorus.Methods: This video illustrates the STESD procedure in an 8-year-old Chinese boy. With a congenital pseudo-pyloric stricture that occurred proximal to the original pylorus, he was suffering from recurrent vomiting, epigastric pain and growth retardation. A gastroscopy demonstrated pseudo-pyloric stricture with severe reflux esophagitis. STESD was performed according to the standard protocol (step 1: mucosal incision; step 2: submucosal tunneling; step 3: septum division; step 4: mucosal closure.) with appropriate preoperative and postoperative care.Results: The operation time was 35minutes.Intraoperative pneumoperitoneum was relieved by paracentesis. The pseudo pylorus disappeared and symptoms were completely relieved after the procedure. The patient was discharged uneventfully at postoperative day 10. In four-month followup, we observed complete symptom resolution, significant improvement of nutritional status and no complications.Conclusion: We suggest STESD as a safe and efficient technology in treating congenital pseudopylorus. Validation in other benign strictures of the gastrointestinal tract is warranted.

Keywords

STESD; Pseudo-pylorus; Congenital; Endoscopic treatment

Cite the article

Liu X, Fang Y, Yang H-B, Ren X-X, Han Y-N, Li Q-L, et al. Submucosal Tunneling Endoscopic Septum Division for Congenital Pseudo-Pylorus: A New Technology in a Rare Disease (With Video). Clin Surg. 2018; 3: 2169.